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Chiropractic cervical manipulation is a common practice utilized around the world. Most patients are never cleared medically for manipulation, which can be devastating for those few who are at increased risk for dissections. The high velocity thrust used in cervical manipulation can produce significant strain on carotid and vertebral vessels. Once a dissection has occurred, the risk of thrombus formation, ischemic stroke, paralysis, and even death is drastically increased. In this case report, we highlight a case of a 32-year-old woman who underwent chiropractic manipulation and had vertebral artery dissection with subsequent brainstem infarct. She quickly deteriorated and passed away shortly after arrival to the hospital. Although rare, one in 48 chiropractors have experienced such an event. We utilize this case to highlight the risk associated with cervical manipulation and urge open dialogue between chiropractors and physicians. Receiving medical clearance prior to cervical manipulation in potential at risk patients would drastically reduce morbidity and mortality.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016850 | PMC |
http://dx.doi.org/10.15761/BRR.1000110 | DOI Listing |
J Surg Case Rep
January 2025
Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland.
The diffuse large B-cell lymphoma (DLBCL) mimicking an epidural hematoma in the cervical spine is an extremely unique case. We present a case of a 42-year-old man, who presented to the emergency department with symptoms of tetraparesis after a session of spinal manipulation therapy. magnetic resonance imaging visualized a lesion located at C3-C7 causing spinal cord compression with surrounding soft tissue edema suggesting epidural hematoma.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Department of Spine and Orthopedic Surgery, Wuzhou Red Cross hospital, #3-1, Xin Xing Road 1, Wuzhou, 543000, China.
Purpose: This study aimed to investigate the effect of precooling storage of bone cement in percutaneous vertebroplasty(PVP) for the patients with osteoporotic vertebral compression fracture (OVCF).
Methods: A total of 207 OVCF patients who underwent PVP were included in this study. Two different storage methods for the bone cement were randomly utilized: an operating room (NT group, 23 °C) and a refrigerator (PC group, 4 °C).
Compr Physiol
December 2024
School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA.
The evolution of mechanisms for terrestrial locomotion has resulted in multi-segmented limbs that allow navigation on irregular terrains, changing of direction, manipulation of external objects, and control over the mechanical properties of limbs important for interaction with the environment, with corresponding changes in neural pathways in the spinal cord. This article is focused on the organization of these pathways, their interactions with the musculoskeletal system, and the integration of these neuromechanical circuits with supraspinal mechanisms to control limb impedance. It is argued that neural pathways from muscle spindles and Golgi tendon organs form a distributive impedance controller in the spinal cord that controls limb impedance and coordination during responses to external disturbances.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology, Unidade Local de Saúde (ULS) de São José, Hospital Dona Estefânia, Lisbon, PRT.
Managing sedation in pediatric patients with complex facial anomalies and airway challenges requires careful consideration of safety and efficacy. This case report presents the use of the Ketodex sedation protocol, combining ketamine (NMDA receptor antagonist) and dexmedetomidine (alpha-2-agonist), for a child with a large cervical/facial mass undergoing a diagnostic magnetic resonance imaging (MRI). Ketodex provides effective sedation with minimal need for manipulation of the airway and side effects, making it ideal for cases involving difficult airways.
View Article and Find Full Text PDFChiropr Man Therap
December 2024
Logan University, 1851 Schoettler Rd, Chesterfield, MO, 63139, USA.
Background: Despite the progress made in better understanding the potential mechanisms of spinal manipulative therapy (SMT) and its treatment effects, a knowledge gap continues to exist when identifying the specific factors that contribute to the perceived treatment effect associated with SMT. The purpose of the study was to explore the perceptions of chiropractic clinicians, interns, and patients regarding what factors during a doctor-patient encounter contribute to the perceived treatment effect associated with SMT.
Methods: This study used convenience sampling to enroll participants from a chiropractic teaching clinic in the United States.
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